Testing It Up

Heart attack can be triggered by air pollution, to the same extent as other known individual risk factors that include physical exertion, alcohol, and coffee, according to a feature on Medical News Today.

The findings were written by Dr Tim S Nawrot, Hasselt University, Diepenbeek, Belgium and Catholic University of Leuven, Belgium, and colleagues from both institutions, and they appear in an Article Online First and in Lancet. In addition to the findings on air pollution, other factors that could trigger heart attacks to varying extents were identified as anger, positive emotions, sexual activity, cocaine or marijuana use and respiratory infections.

The findings were the result of data from 36 separate studies. The mean participant age for cocaine and marijuana use was 44 years, while that for respiratory infection studies was 72 years. The relative risk posed by each trigger was calculated by the authors, as was the proportion of total heart attacks that may have been caused by that trigger, also known as the population-attributable fraction (PAF).

Air pollution actually increased the risk of triggering a heart attack by 5 percent, compared against a 23 times increased risk brought about by cocaine. However, if the fact that the entire population is exposed to air pollution while only 0.02 percent is exposed to cocaine is considered, it comes out that air pollution can trigger more heart attacks than cocaine.

“Of the triggers for heart attack studied, cocaine is the most likely to trigger an event in an individual, but traffic has the greatest population effect as more people are exposed to the trigger…PAFs give a measure of how much disease would be avoided if the risk was no longer present,” the authors said.

A study revealed that doctors can use three simple tests, in order to determine whether a recovering stroke patient is ready to drive, according to a feature by HealthDay.

Hannes Devos, review author and a research assistant at Katholieke Universiteit Leuven in Belgium, shared that “A quick and objective screening in the doctor’s office can help them make more accurate decisions.”

Stroke patients may have to ask their doctors for approval before they can legally begin driving again. Devos shared, however, that there are doctors who “do not feel confident to screen for fitness to drive because they lack standardized tools that can be administered in the doctor’s office.”

Devos and his colleagues used this challenge as the basis for conducting a review of 30 surveys, 27 of which were included in an overall statistical analysis. The researchers identified three screening tests, which had accuracy levels of 80 percent to 85 percent, in determining how a patient will perform during an on-road driving test. The three tests require patients to do the following:

• Match road signs to driving situations
• Match cue cards in a mockup of a driving roundabout or rotary
• Connect 25 circles while alternating between numbers and letters in consecutive order

The tests, according to Devos, take only about 15 minutes to administer during a routine doctor’s visit.

Some doctors, however, are not sure about using the tests. Dr. Larry B. Goldstein, professor of medicine and director of the Duke Stroke Center at Duke University Medical Center, shared: “I am not sure whether it is practical to include a formal driving assessment as part of the routine post-stroke follow-up visit or whether the cost would be reimbursed.”

A feature on BBC.co.uk shared a device developed by researchers at the University of Leicester, and in Singapore, that scientists say may “revolutionize blood pressure monitoring.”

The device can be worn around a patient’s wrist, like a watch, and measures pressure in the largest artery in the body. The feature shared that there is evidence that supports the fact that the device can give a much more accurate reading than an arm cuff. A sensor in the device records the pulse wave of the artery, then feeds this information into a computer, along with traditional blood pressure reading from a cuff.

This allows scientists to read the pressure close to the heart, from the aorta.

According to Professor Bryan Williams of the department of cardiovascular sciences at Glenfield Hospital, University of Leicester, shared: “The aorta is millimetres away from the heart and close to the brain and we have always known that pressure here is a bit lower than in the arm. Unless we measure the pressure in the aorta we are not getting an appreciation of the risks or benefits of treatment.”

Prof. Williams also shared that it was important for the researchers to ensure that the device is made as small as possible, so that clinicians and patients are encouraged to use the device.

Funding for the development of the technology came from the National Institute of Health Research of the Department of Health, backed by Health Secretary Andrew Lansley, who said: “This is a great example of how research breakthroughs and innovation can make a real difference to patient’s lives.”

Two more studies link having a drink or two each day to a healthy heart.

A feature on Bloomberg BusinessWeek shared the efforts of a team of researchers from the University of Calgary, who conducted a review of 84 studies that looked into alcohol consumption and heart disease. Their analysis indicated that people who consumed alcohol moderately – with moderation defined as having one drink or less per day – are 14 to 25 percent less likely to develop heart disease, when compared against those who do not drink alcohol at all.

As in previous studies of that nature, the researchers of the first paper stress the fact that the benefits of alcohol consumption is anchored upon moderation; when alcohol consumption goes beyond moderation, these benefits are lost.

Another team of researchers, also from the University of Calgary, conducted a review of 63 researches, and determined that moderate alcohol consumption may lead to a significant increase in the levels of “good” cholesterol. Such an increase protects people against heart disease. In addition, they concluded that health benefits are provided by alcohol content, and not the type of alcoholic beverage consumed.

Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hospital in New York City, commented: “”In addressing lifestyle issues, alcohol consumption, in moderation, could be recommended as part of a heart-healthy lifestyle… One of the mechanisms of decreasing heart disease is by increasing the HDL ['good' cholesterol], which is independent of the type of alcohol, whether it be wine, beer or spirits.”

The findings from both researches were published online in the BMJ.

New York Health Screening

A study conducted by Marianne Benn, MD, PhD, of Copenhagen University Hospital in Denmark and colleagues, linked elevated levels of non-fasting triglycerides, not cholesterol levels, to an increased risk of ischemic stroke, as shared in a feature on MedPage Today.

Stroke prevention guidelines that are currently in place give advice on managing cholesterol, but not non-fasting triglycerides.

The Danish study determined that the hazard ratio for ischemic stroke in women whose triglyceride levels were at 5 mmol/L or higher was 3.9 (95% CI 1.3 to 11.1, P for trend <0.001), when compared against women with levels below 1 mmol/L. Among men, the hazard ratio for those with high triglyceride levels was 2.3 (95% CI 1.2 to 4.3, P for trend =0.001).

According to the researchers, “Elevated nonfasting triglycerides are markers of elevated levels of cholesterol in lipoprotein remnants thought to be atherogenic in the same way as low-density lipoprotein (LDL) cholesterol, by accumulation in the arterial wall.”

The Danish team conducted an analysis of data from the Copenhagen City Heart Study, in order to see whether there was a link between non-fasting triglycerides and ischemic stroke. The study’s participants consisted of 7,579 women and 6,372 men, with measurements of cholesterol and triglycerides at baseline between 1976 and 1978.

Higher levels of cholesterol, however, were not linked to an increased risk for ischemic stroke among women, based on the results of the study. An association was found among men, but only in those whose cholesterol was 9 mmol/L (HR 4.4, 95% CI 1.9 to 10.6).

Sexually-transmitted diseases (STD) may be developed by as many as half of young people who are sexually active, but a lot of them may not get tested for a variety of reasons: they either cannot afford to have one, or are embarrassed to undergo STD testing.

A feature on the Los Angeles Times shared efforts aimed at reaching out to these young people, and ensuring that they get the tests that they need.

One such effort is a program called “I Want the Kit,” which was developed with the help of Charlotte A. Gaydos, a professor of infectious diseases at Johns Hopkins University in Baltimore. The website gives out free testing kits for three of the most common STDs: gonorrhea, chlamydia, and trichomoniasis.

Prof. Gaydos shared: “The highest prevalence is in young adults, and we knew we had to reach these kids… They were always on the Internet, and now, on their smart phones. They weren’t going to ask their mothers to take them to a clinic.”

I Want the Kit serves teens and young adults in Maryland, Washington, West Virginia, parts of Illinois, Denver, and Philadelphia. Each kit provided by Hopkins, which cost anywhere from $65 to $70 (including cost of mailing, test and lab worker time), is mailed in a plain envelope, and contains the swab, questionnaire, information about STDs, and consent form. People can access the website via Facebook or through a smart phone application. The app reads barcodes printed on program brochures; these brochures are left in schools and clinics.

A favorite topic of discussion in New York these days may be the smoking bans that will be implemented in the city in the summer. Smoking cessation efforts are something that various governments are engaging in, and while there are those who find NYC laws a bit too intrusive, these pale in comparison to a law that took effect Monday in Honduras.

A report by the Associated Press shared that the new measure “bans smoking in most public or private spaces.” These include schools, gas stations, night clubs, restaurants, bars, buses, taxis, stadiums, and cultural centers. In addition, it stipulates that smokers should stand at least six feet away from non-smokers in any open space.

While the law does not specifically ban smoking at home, it does include a clause that says that family members and visitors can call in the police to deal with smokers at home: “Families or individuals may complain to law enforcement authorities when smokers expose them to secondhand smoke in private places and family homes.”

Violators of the law will initially receive a verbal warning after the first offense, and may face arrest – and a $311 fine – after the second offense. $311 is the equivalent of a monthly minimum wage salary in Honduras.

Rony Portillo, director of the Institute to Prevent Alcoholism and Drug Addiction, said: “The law is clear and we will comply with it… Authorities will intervene (at a home) when someone makes a complaint.”

How law enforcers will be able to do that, however, is a question for some; Honduras has 12,000 police officers, a total population of 8 million people – and a rampant crime problem.

Jose Martinez, a computer engineer and a smoker for 20 years, said: “Police won’t be able to enforce it because they can barely keep up with the crime wave that has been overwhelming us to be able to go after those who are smoking at home.”

New York Health Screening

The results of a recently-released study featured on DrugWatch.com indicated a link between amphetamine use and Parkinson’s disease.

The study analyzed data from 66,348 participants, who were followed for almost 40 years. Upon their enrollment into the study, participants were asked whether they had taken weight loss drugs. They were also specifically asked whether they had taken the amphetamines Benzedrine or Dexedrine.

Based on the results of the study, researchers determined that patients who had taken the amphetamines developed Parkinson’s disease at a higher rate, when compared against those who had admitted to taking weight-loss drugs, but did not take Benzedrine or Dexedrine.

Amphetamines are usually prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy; it is also sometimes prescribed for obesity. They regulate the release and absorption of dopamine, a chemical messenger that is present in low levels among those who suffer from Parkinson’s disease.

Parkinson’s disease, on the other hand, is a chronic neurological illness characterized by a progressive loss of movement control. It is the second most prevalent neurological illness in the United States, after Alzheimer’s disease. Actor Michael J. Fox and boxer Muhammad Ali are among the famous people who are dealing with Parkinson’s disease; the late Pope John Paul II also suffered from Parkinson’s.

The results of the study, however, were only able to suggest an association between use of prescription amphetamines and the development of Parkinson’s disease, as opposed to a causal relationship. An assessment of the exact link between the two factors can only be done through further research.

We found this interesting video on Yahoo! News Weekend Edition, which features best-selling author Dr. Brian Wansink, Ph.D. of the Food and Brand Lab at Cornell University.

Dr. Wansink is the brains behind the terms “mindless eating” and “health halos,” and is best known for his research regarding how the immediate environment influences eating habits and preferences. When it comes to eating, a few tweaks in the environment, and the ambience, in which you eat can influence how much you end up eating.

Yahoo!’s Dominique Dawes learned various tips from Dr. Wansink, which ranged from the colors of kitchen walls (neutral colors are best) to the size of plates (smaller plates mean smaller servings).

The tips are outlined in Dr. Wansink’s book, “Mindless Eating: Why We Eat More Than We Think.”

Aside from wall colors and plate size, Dr. Wansink shared that even the design of the plate can influence how much we eat. In general, less white means less food on the plate, so a plate with designs on the rim, for instance, should help one eat less. Serving up soda and other calorie- and sugar-rich beverages in wide-mouthed glasses usually lead to more servings, as opposed to tall, slim glasses. Smaller serving spoons also lead to smaller servings.

A big no-no is eating in front of the TV, according to Dr. Wansink. It causes one to space out and not think about how many calories one is eating, among other things, because one is distracted by the TV.

Dr. Wansink leaves a piece of wisdom, when it comes to dieting: “The best diet is the diet you don’t know you’re on.”

Breast lumps are among the more common signs associated with breast cancer, and 40 percent of women are likely to discover a lump in their breasts at some point in their lives. That being said, however, finding a breast lump does not necessarily mean that one found breast cancer as well; a feature on WebMD shared a few myths regarding breast lumps.

Breast lumps = breast cancer. We start off with the most common myth about breast lumps: that it almost always means breast cancer. This is not so, so there is no need to panic immediately if one feels a lump in one or both breasts. But one should also not brush it off altogether; experts who shared with WebMD advice that it is important for lumps to get evaluated, no matter what the cause may be. There may be several, other than cancer: a cyst; an abnormal, non-cancerous growth such as a fibroadenoma; a blood clot; or a “pseudo-lump” brought about by hormonal changes.

Dr. Stephen Sener, past president of the American Cancer Society and professor of surgery at the Keck School of Medicine, University of Southern California, suggests getting a physical examination, a mammogram, or an ultrasound; other women may have to get a biopsy.

A lump in women with a history of cysts cannot be cancer. Women who have had cysts multiple times sometimes become complacent and assume that a new lump is just another cyst, and therefore nothing to worry about. Dr. Laura Kruper, a breast cancer surgeon at the City of Hope Comprehensive Cancer Center in Duarte, California, said that doctors need to know about anything new that appears.